Provider Demographics
NPI:1588419568
Name:URZUA CASIAN, REYNA TATIANA
Entity type:Individual
Prefix:
First Name:REYNA
Middle Name:TATIANA
Last Name:URZUA CASIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E SAN JOAQUIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2945
Mailing Address - Country:US
Mailing Address - Phone:831-424-5033
Mailing Address - Fax:831-424-5044
Practice Address - Street 1:30 E SAN JOAQUIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2945
Practice Address - Country:US
Practice Address - Phone:831-424-5033
Practice Address - Fax:831-424-5044
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist